Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OC...

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Autores principales:	Kase S, Saito W, Mori S, Saito M, Ando R, Dong Z, Suzuki T, Noda K, Ishida S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	inverted ILM flap glial cells OCT macular hole histopathology. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/56083700cb46499c81383dfaab7d539d
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spelling	oai:doaj.org-article:56083700cb46499c81383dfaab7d539d2021-12-02T02:18:09ZClinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique1177-5483https://doaj.org/article/56083700cb46499c81383dfaab7d539d2016-12-01T00:00:00Zhttps://www.dovepress.com/clinical-and-histological-evaluation-of-large-macular-hole-surgery-usi-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OCT) imaging of large macular holes (MHs) treated with inverted internal limiting membrane (ILM) flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy.Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV) with inverted ILM flap technique assisted by brilliant blue G (BBG) staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP).Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%). Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration.Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. Keywords: inverted ILM flap, glial cells, OCT, macular hole, histopathologyKase SSaito WMori SSaito MAndo RDong ZSuzuki TNoda KIshida SDove Medical Pressarticleinverted ILM flapglial cellsOCTmacular holehistopathology.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 9-14 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	inverted ILM flap glial cells OCT macular hole histopathology. Ophthalmology RE1-994
spellingShingle	inverted ILM flap glial cells OCT macular hole histopathology. Ophthalmology RE1-994 Kase S Saito W Mori S Saito M Ando R Dong Z Suzuki T Noda K Ishida S Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
description	Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OCT) imaging of large macular holes (MHs) treated with inverted internal limiting membrane (ILM) flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy.Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV) with inverted ILM flap technique assisted by brilliant blue G (BBG) staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP).Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%). Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration.Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. Keywords: inverted ILM flap, glial cells, OCT, macular hole, histopathology
format	article
author	Kase S Saito W Mori S Saito M Ando R Dong Z Suzuki T Noda K Ishida S
author_facet	Kase S Saito W Mori S Saito M Ando R Dong Z Suzuki T Noda K Ishida S
author_sort	Kase S
title	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
title_short	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
title_full	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
title_fullStr	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
title_full_unstemmed	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
title_sort	clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/56083700cb46499c81383dfaab7d539d
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Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

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